Dietary sodium intake and prediction of cardiovascular events

Abstract

Background/Objectives: The association of dietary sodium and cardiovascular disease (CVD), as well as the reduction of sodium intake in the prevention of CVD, has been under debate. To study whether sodium consumption has a role as a risk factor for fatal and non-fatal CVD. Subjects/Methods: A well-defined population-based cohort of 1045 subjects collected between 1991 and 1993 (mean age 51.4 years) was used with approximately 19 years' follow-up. At the baseline, 716 subjects filled in a 1-week food follow-up diary, which was used to calculate the daily sodium intake (mg/1000 kcal). Results: The baseline sodium intake correlated significantly with age (r s =0.117, P=0.002), BMI (r s =0.216, P=0.000), waist circumference (r s =0.268, P=0.000), smoking (r s =0.144, P=0.000), alcohol consumption (r s =0.111, P=0.003), systolic blood pressure (r s =0.106, P=0.005) and low-density lipoprotein (LDL) cholesterol (r s =0.081, P=0.033). Those who had cardiovascular events in the follow-up consumed more sodium at the baseline (mean 2010.4 mg/1000 kcal/day, s.d. 435.2, n=101) compared with the subjects without events (mean 1849.9 mg/1000 kcal/day, s.d. 361.2, n=589; t-test; P=0.001). The incidence of cardiovascular events was greater in the highest quartile (22.1%) than in the lower quartiles (first 11.0%, second 9.9% and third 15.6%; X 2; P=0.005). Cox regression analysis showed that sodium intake as a continuous variable predicts CVD events (P=0.031) independently when age, sex, smoking, alcohol consumption, systolic blood pressure, LDL cholesterol and waist circumference were added as covariates. This predictive role is seen especially in the group of subjects on hypertensive medication (P=0.001). Conclusions: Dietary sodium intake is a significant independent predictor of cardiovascular events in the study population.